DIAGNOSTIC REASONING AND TREATMENT PLANNING: 1. DIAGNOSIS

Information-processing research into the natural process of clinical reasoning is reviewed and the University of Vermont diagnostic reasoning research project is described. Experienced psychiatric diagnosticians use a hypothetico-deductive logic. The development of a profile of diagnostic competencies is outlined and a course in diagnostic reasoning for medical students, which specifically objectified the tactics and strategy of reasoning and resulted in a significant improvement in the profile of competencies, is described. Finally, the organisation of a diagnostic formulation is discussed. It is hard to think about thinking. No wonder, then, that research into clinical reasoning has been impeded by obstacles and rift by controversy. In the meantime, physicians have no alternative but to learn to tackle diagnostic problems as they go along. Many, it is true, wil